Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Treatment of acute ischemic stroke with the low-molecular-weight heparin certoparin: Results of the TOPAS trial
Autore:
Diener, HC; Ringelstein, EB; von Kummer, R; Langohr, HD; Bewermeyer, H; Landgraf, H; Hennerici, M; Welzel, D; Grave, M; Brom, J; Weidinger, G;
Indirizzi:
Univ Essen Gesamthsch Klinikum, Neurol Klin & Poliklin, D-45122 Essen, Germany Univ Essen Gesamthsch Klinikum Essen Germany D-45122 5122 Essen, Germany Univ Munster, D-4400 Munster, Germany Univ Munster Munster Germany D-4400 niv Munster, D-4400 Munster, Germany Univ Dresden, Dresden, Germany Univ Dresden Dresden GermanyUniv Dresden, Dresden, Germany Klinikum Fulda, Fulda, Germany Klinikum Fulda Fulda GermanyKlinikum Fulda, Fulda, Germany Krankenhaus Koln Merheim, Cologne, Germany Krankenhaus Koln Merheim Cologne Germany Koln Merheim, Cologne, Germany Wenckebach Krankenhaus, Berlin, Germany Wenckebach Krankenhaus Berlin Germany bach Krankenhaus, Berlin, Germany Univ Klinikum Mannheim, Mannheim, Germany Univ Klinikum Mannheim Mannheim Germany kum Mannheim, Mannheim, Germany Univ Regensburg, D-8400 Regensburg, Germany Univ Regensburg Regensburg Germany D-8400 rg, D-8400 Regensburg, Germany Novartis Pharma, Nurnberg, Germany Novartis Pharma Nurnberg GermanyNovartis Pharma, Nurnberg, Germany
Titolo Testata:
STROKE
fascicolo: 1, volume: 32, anno: 2001,
pagine: 22 - 29
SICI:
0039-2499(200101)32:1<22:TOAISW>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
COOPERATIVE ACUTE STROKE; THROMBOLYTIC THERAPY; ASPIRIN; DAMAGE; ECASS;
Keywords:
heparin; stroke, acute; stroke, ischemic; stroke management; thrombosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Diener, HC Univ Essen Gesamthsch Klinikum, Neurol Klin & Poliklin, Hufelandstr 55, D-45122 Essen, Germany Univ Essen Gesamthsch Klinikum Hufelandstr 55 Essen Germany D-45122
Citazione:
H.C. Diener et al., "Treatment of acute ischemic stroke with the low-molecular-weight heparin certoparin: Results of the TOPAS trial", STROKE, 32(1), 2001, pp. 22-29

Abstract

Background and Purpose-To study the safety and efficacy of the low-molecular-weight heparin certoparin, we performed a randomized, double-blind, dose-finding multicenter trial in patients with acute ischemic stroke (Therapy of Patients With Acute Stroke [TOPAS]). Methods-we randomized 404 patients to 4 treatment groups within 12 hours of stroke onset: 3000 U anti-factor Xa (aXa) certoparin once daily (treatment group 1); 3000 U aXa twice daily (group 2); 5000 U aXa twice daily (group3); and 8000 U aXa twice daily (group 4). The primary efficacy variable was the proportion of patients reaching a favorable functional outcome (Barthel Index greater than or equal to 90 points) at 3 months. CT was performed at trial entry, after 7 days, and on clinical deterioration. Results-The proportion of patients with Barthel Index greater than or equal to 90 was not different between treatment arms (61.5%, 60.8%, 63.3%, and 56.3% in the 4 groups, respectively; intent-to-treat population). European Stroke Scale scores improved in all treatment groups within the first 14 days to a similar extent. During the follow-up of 6 months, percentages of patients with recurrent stroke/transient ischemic attack were 11.0%, 5.9%, 9.7%, and 13.0% in the 4 groups, respectively. Overall mortality was only 7.4%. Two parenchymal cerebral hematomas and 1 extracranial bleeding episode occurred in treatment group 1 versus 1 and 0 in group 2, 2 and 0 in group 3,and 4 and 5 in group 4, respectively. During certoparin treatment, 1 deep vein thrombosis but no pulmonary embolism was observed. Conclusions-Dose increase of certoparin up to 8000 U aXa twice daily did not improve the functional outcome of patients with ischemic stroke. Severe bleeding tended to be more frequent in the highest dose group only.

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Documento generato il 20/01/21 alle ore 02:15:51